The Physician Sunshine Act, a component of the ACA, has been in place since October of last year. It requires pharmaceutical companies to collect and track all financial relationships with physicians and teaching hospitals. The goal of the law is to enhance patient safety by increasing the transparency of financial relationships between health care providers and the pharmaceutical industry.
In about two months, the first public reports will hit the CMS website. Many physicians are apprehensive about this report and how it will be received by the public. Some physicians have chosen to distance themselves from the industry in advance in order to avoid the potential adverse publicity of showing up on these lists. Relationships between physicians and drug companies have already been strained over the years, and now there is the perception by some that this Sunshine Act will further erode these relationships.
I have had several gratifying speaking and consulting relationships with pharmaceutical companies over the years and I believe this law has the ability to actually better clarify and enhance the relationship between physicians and Pharma.
First of all, I have always been a strong advocate of transparency in the health care industry and I frequently speak about embracing transparency as a way to do business. Transparency has had very positive effects on quality measures and patient experience. I believe we can see similar benefits with pharmaceutical companies as this program evolves.
Physicians are in the unique position to truly benefit the pharmaceutical industry by providing unbiased professional expertise on the most appropriate use of their products. Additionally, physician experts are in an ideal position to positively influence other physicians on the products’ appropriate indications and roles in patient management through the implementation of best practices.
There is a fear that the publications of fees received by Pharma could be a conflict for the physician, especially in regards to treating patients and being objective to the organizations to which the physician may belong. Actually, I believe the transparency and accountability will be positive for the physician if the relationship with the pharmaceutical company is structured in the right manner.
I would like to offer some guiding principles that I use when I consider a relationship, either speaking or consultative, with a pharmaceutical company.
1. Advocate the clinical concept, not the drug. Choose the pharmaceutical company that you might work with on the basis of the desire to implement best clinical practices, under which the use of their product might fit. You need to champion the clinical process, not the use of the product. This entails advocating the optimal use of the best practice– when it should be used and when it should NOT be used. Transparency and best practices are aligned. Put simply, you advocate the prudent and evidence-based practice of medicine, which is what the prudent physician does in the first place.
2. If you are seeing patients, disclose this relationship to them– once again stressing the importance of disseminating best clinical practices that you advocate, especially if you are prescribing that medication to the patient. Emphasize how your relationship with the pharmaceutical company helps promote prudent medical practices and ultimately helps teach the medical community how to practice better medicine.
3. Disclose this relationship with your organization upfront . Personally, I like to educate any applicable Board and make sure the Board is comfortable with the arrangement. If you are an employed physician, discuss the matter with your supervising physician and get the appropriate approval. No one wants to be surprised by a public report and have to scurry to defend it– even if it is all above board.
4. Review the CMS data for accuracy regularly prior to the posting. The CMS website is fairly easy to navigate. I have no doubt that this report will have errors and it is in your best interest to find that out, correct it as necessary, and be better prepared for the actual posting.
I realize that there may have been abuses in the past that have forced such legislation, but lets use this opportunity as a way to educate the pharmaceutical industry and better spread transparency, accountability and best practices amongst our colleagues and the medical community in general.
Focus our efforts to improve education and spreading best practices…. After all, that’s just being a good doctor.